4-Anti-Human Trafficking Affidavit.docx

DOCX document 40 KB Posted

Attached to
Pavement Resurfacing and Repair Services
Solicitation number
PNC2130637B1
Issued by
Florida

About this file

This is an Anti-Human Trafficking Affidavit form required by Broward County, Florida for vendor submissions related to the Pavement Resurfacing and Repair Services contract opportunity. The affidavit must be completed and returned with the vendor's initial submittal, or if not provided, within three business days of the County's request and upon contract award, renewal, or extension. Vendors must declare under penalties of perjury that they do not use coercion for labor or services as defined in Section 787.06, Florida Statutes. The form requires the vendor to provide their company name, authorized representative signature, printed name, title, and date of execution. Failure to fully comply with submission requirements within the stated timeframe may result in the vendor being deemed nonresponsive.

The Pavement Resurfacing and Repair Services contract encompasses the furnishing of all labor, materials, equipment, services, and incidentals required to perform roadway milling, resurfacing, pavement markings, miscellaneous pavement repair activities, and maintenance of traffic in compliance with applicable building, safety, technical, and related codes and laws. Vendor responses must be submitted electronically through BPRO by the specified closing date and time, with vendors responsible for ensuring receipt of their submission receipt. The solicitation requires compliance with County Surtax Funding, County/State License Requirements, Bonding Requirements, and County Business Enterprise (CBE) Goal Participation requirements established by the Office of Economic and Small Business Development (OESBD).

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Text version

ANTI-HUMAN TRAFFICKING AFFIDAVIT

This completed form should be returned with the Vendor’s submittal. If not provided with the submittal, the Vendor must submit this form within three (3) business days after the County’s request and upon award, renewal, or extension of a contract with Broward County. The Vendor may be deemed nonresponsive for failure to fully comply within the stated timeframe.

The Vendor indicated below does not use coercion for labor or services, as such terms are defined in Section 787.06, Florida Statutes.

Under penalties of perjury, the undersigned declares that they have read the foregoing statement and that the facts stated in it are true.

Vendor Name: Click or tap here to enter text.

Signature:

Printed Name: Click or tap here to enter text.

Title: Click or tap here to enter text.

Date: Click or tap to enter a date.

Form Date 9/9/24

File details come from the government source that posted it. Updated .